HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 10/25/18 Permit Number:
o -
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone:(772)462-1553 Fax:(772)462-1578 Commercial Residential Y
PERMIT,,.APPLICATION FOR: Concrete
PROPOSED IMPROVEMENT LOCATION:
Address: 6108 DELEON AVE., FORT PIERCE, FL
Legal Description: LAKEWOOD PARK-UNIT 10-BLK 132 LOT 26 (MAP 13/01 S) (OR 3847-671)
Property Tax ID#: 1301-612-0342-000-5 Lot No.26
Site Plan Name: Block No. 132
Project Name:
HUNT PARKING SLAB Ca
i -e-
39
Setbacks Front 2' Back: 25' Right Side: 15' Left Side: 66.23'
DETAILED DESCRIPTION OF WORK:
INSTALL NEW CONCRETE SLAB FOR PARKING L41 JR 1-C X
CONSTRUCTION INFORMATION:
Additional work to be nertormed under this-permit—c heck all appy:
HVAC Gas Tank Gas Piping _Shutters Q Windows/Doors
i
11 Electric Plumbing Sprinklers Generator Roof Roof pitch
Total Sq.Ft of Construction: 2000 SF S . Ft.of First Floor: N/A
7,000.00 N/A
Cost of Construction:$ Utilities: Sewer Septic Building Height: �
OWNER/LESSEE: CONTRACTOR:
Name - Name: PAUL KUHN
Address: (;(05? DELE64) 7)_,lf Company: HERITAGE CONTRACTING SERVICES, INC
City: State: Z Address:3690 N US HWY 1
��or ;
Zip Code: 3�(9s1 '.`, .,Fax: City: FORT PIERCE '' . State:FL
Phone No: 77 - $70 qg,5-7 Zip Code: 34946 - Fax: N/A
E-Mail:: Phone No. 772-216-6612
Fill in fee simple Title Holder on next page(if different E-Mail: PAUL.K.HCS@GMAIL.COM
from the Owner listed above) State or County License: FLCGC1507158
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: X Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address:3690 N US HWY 1 Address:
City: City:
Zip: Phone: Zip: Phone:
OWNER/CONTRACTOR AFFIDVIT:Application is hereby made to obtain a permit to do the work and installation as indicated.
I certify that no work or installation has commenced prior to the issuance of a permit.
St.Lucie County makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules,bylaws or and covenants that may restrict or prohibit such
structure.Please consult with your Home Owners Association and review your deed for any restrictions which may apply.
In consideration of the granting of this requested permit,I do hereby agree that I will,in all respects,perform the work
in accordance with the approved plans,the Florida Building Codes and St.Lucie County Amendments.
The following building permit applications are exempt from undergoing a full concurrency review:room additions,
accessory structures,swimming pools,fences,walls,signs,screen rooms and accessory uses to another non-residential use
WARNING TO OWNER:Your failure to Record a Notice of Commencement may result in your paying twice for
improvements to your property.A Notice of Commencement must be recorded and posted on the jobsite
before the first inspection. If you intend to obtain financing,consult with lender or an attorney before
cornme.peing work or recoroing your Notice of Commencement.
)G Y'11_ n
Signature of Owner/Lessee/Contractor as Agent for Owner, Signature of Contractor License Hold'br-
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF A COUNTY OF � _c om,
The for oing instrument was acknowledge before me The forgoing instru nt was acknowledged before me
this day of nu-y 20� by thi day of 26f2_ by
Name of person making statement Name o person making statement
Personally Knowny OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identification
Produced Produced
S' ature of Notary Public-State o Florida) (Signature of Notary Public-StRA of Florida)
Commission No": �- -'`(S'e Commission No. r- ;. �,-_� ASeal)3sfl f
Ptiep- LASHAHNA INGRAM �� ,LPSHAI-INA INGRAM
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3�2* „;A Notary Public State of Florida ?2 w ��, Notary Public-State of Florida
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